Provider Demographics
NPI:1093187866
Name:HOUSE OF EYES OF GREENSBORO INC.
Entity Type:Organization
Organization Name:HOUSE OF EYES OF GREENSBORO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-852-7107
Mailing Address - Street 1:2222 PATTERSON ST
Mailing Address - Street 2:STE A
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-2543
Mailing Address - Country:US
Mailing Address - Phone:336-852-7107
Mailing Address - Fax:
Practice Address - Street 1:2222 PATTERSON ST
Practice Address - Street 2:STE A
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-2543
Practice Address - Country:US
Practice Address - Phone:336-852-7107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-20
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC600578257156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty